Short screening scales to monitor population prevalences and trends in non-specific psychological distress

Gay Community Stress in Sexual Minority Men and Women: A Validation Study in the Netherlands

Intraminority gay community stress theory posits that social stressors within sexual minority communities of men may be risk factors for mental health problems in gay and bisexual men. The recently developed 20-item Gay Community Stress Scale (GCSS) is a valid and reliable measure of gay community stress, but was not yet validated in the Netherlands. This study developed a Dutch-translated version of the GCSS and validated this scale in sexual minority men and sexual minority women, as it was hypothesized that sexual minority women may also experience intraminority stress. Exploratory and confirmatory factor analyses were subsequently performed in independent samples of men and women, and produced a 16-item GCSS for men and a 12-item GCSS for women. The four-factor structure of the original GCSS was replicated in men and women, and encouraging support for discriminant and concurrent validity of the GCSS was found in both men and women. The total scale and subscales were internally consistent in men (α and ω ≥ .87) and in women (α and ω ≥ .78). The Dutch-translated GCSS seems to offer a valid and reliable way to assess intraminority stress in Dutch-speaking sexual minority men and sexual minority women, although further validation is warranted.

Safety plan use and suicide-related coping in a sample of Australian online help-seekers

BACKGROUND

Suicide safety plans can improve suicide-related coping skills and reduce suicidal thoughts and behaviours (STBs). However, little is known about their use and impact outside of treatment settings, where most suicidal crises will occur. The current study explored the prevalence of safety plan use among an online sample of help-seekers with lifetime STBs, and whether STBs and suicide-related coping differed between those with and without safety plans. An exploratory aim was to investigate barriers to safety plan use.

METHOD

Participants (N = 1251) completed an online, anonymous survey at a mental health support website (Beyond Blue). The survey measured lifetime STBs, past-month suicidal ideation, suicide-related coping, help-seeking intentions and behaviour.

RESULTS

Despite high levels of past-month suicidal ideation and past-year help-seeking, most participants (89.5 %) did not have a safety plan, and most of those were not familiar with the concept (70.5 %). Participants with safety plans reported a higher rate of past suicide attempts, but higher suicide-related coping and help-seeking behaviour. Among participants without safety plans, negative attitudes toward safety planning were positively associated with suicidal ideation and negatively associated with suicide-related coping.

LIMITATIONS

Participants were primarily female, English-speaking visitors to a mental health support website. Cross-sectional design precludes conclusions being drawn about safety planning effectiveness over time.

CONCLUSION

This study highlights the low prevalence of safety plan use among online help-seekers with lifetime STBs and the need to better promote safety planning as an intervention with autonomous benefits, including crisis preparedness and improved suicide-related coping skills.

Farmers' Mental Health: The Mediating Role of Chronic Fatigue

The agricultural environment is known to be particularly harmful to farmers' psychological health. To better understand how its impact is modulated, this study mainly focuses on the mediating role of chronic fatigue between A) loneliness at work, autonomy, workload, government regulations and policies and financial hardship, and B) life satisfaction, positive affect and psychological distress. The study is based on a sample of 453 Canadian dairy farmers. Structural equation modeling analyses confirmed the mediating role of chronic fatigue in the relationships between the factors studied, with the exception of financial hardship. Implications for research and the psychological burden affecting agricultural workers are discussed.

Psychometric Properties and Factor Structure of the Multidimensional Behavioral Health Screen (MBHS) With a University Sample

The Multidimensional Behavioral Health Screen (MBHS) is a brief screening measure of behavioral health symptoms. Although the measure was first developed for primary care, it is likely to have clinical utility in other settings. This study examined the MBHS's factor structure and psychometric properties with a university undergraduate and graduate student sample (n = 602, 58.6% female, 75.9% White, primarily aged 20-24) during the COVID-19 pandemic. MBHS subscale scores demonstrated internal consistency reliability and both convergent and discriminant relations with external, criterion variables. Confirmatory factor analyses supported a 7-subscale factor structure of the MBHS and did not find evidence of higher order factors. Clinical and theoretical implications, as well as future research directions, are discussed.

Drinking in despair: Unintended consequences of automation in China

The side effects of technological progress on the economy have been discussed frequently, but little is known regarding its health consequences. By combining the national individual-level panel data of alcohol drinking with the prefecture-level robot exposure rate in China, we find that one more robot exposure rate could induce up to 2.2% points increase in the probability of problem drinking. Such a pattern of problem drinking is explained by negative emotions, which can be ascribed to job loss due to substitution, higher income vulnerability, and reduced organization participation. Further, we provide evidence that automation can incur health costs, particularly for easily substituted workers, which would exacerbate health inequality in China. This paper sheds light on the impact of automation and the social incentives of problem drinking, emphasizing the possibly heterogeneous health cost accompanied by the automation process.

Peer Bullying Victimization Trajectories for Sexually and Gender Diverse Youth from Early Childhood to Late Adolescence

Sexually and gender diverse (SGD) youth experience more peer bullying victimization than heterosexual, cisgender youth during adolescence, yet the emergence and persistence of these disparities remain underexplored. Also, it is unclear which factors are associated with these disparities across development, and how these disparities are linked to late adolescent health discrepancies. This study utilized the sample from the Millennium Cohort Study in Britain (N = 10,080; 51.3% assigned female at birth; Mage = 2.28, SDage = 0.46 at Wave 2), in which 23.74% of youth reported non-heterosexual attraction, 21.59% reported non-heterosexual identity, and 1.08% reported gender identity not in line with the sex assigned at birth. Using latent class growth modeling, four peer bullying victimization trajectories were identified, with early peak (7.2%), late childhood peak (6.3%), adolescence onset (12.8%), and low (73.6%) rates of victimization. SGD youth, compared to heterosexual and cisgender youth, were found to have increased odds of being in the victimization-involved classes, especially the adolescence onset class. The study further revealed that SGD youth reported more mental health and relational difficulties in childhood, which were linked to their heightened risk of longer-lasting victimization. Further, long-term victimization was found to partially account for the disparities in health and well-being for SGD youth in late adolescence. In conclusion, SGD youth were more likely to experience longer-lasting bullying victimization during childhood and adolescence, its related mental and relational vulnerabilities were already established in childhood, and such victimization disparities were further linked to their detrimental health and well-being in late adolescence. The design, hypotheses, and target analyses of the current study were preregistered on 21st April 2023 at https://osf.io/f2zxy .

The effect of sociodemographic characteristics, academic factors, and individual health behaviors on psychological well-being among college students

Objective: This study aimed to measure the potential relationships between sociodemographic characteristics, academic factors, body mass index (BMI), financial challenges, individual health behaviors, impact of COVID-19, and psychological well-being (PWB) among students. Participants: Undergraduate college students. Methods: Data from the National College Health Assessment III (American College Health Association [ACHA]) were used (n = 1,439). Differences in absolute values among PWB groups were analyzed using analysis of variance (ANOVA). To measure the influence of all factors combined on PWB, multiple regression analyses were performed. Results: Significant differences were observed in age, GPA, financial challenges, and individual health behaviors by PWB groups (p < .05). Being older, being female, having a higher GPA, being a full-time student, having a higher intake of vegetables, taking less time to fall asleep, and having lower stress levels were significantly positively associated with higher PWB scores (p < .05). Conclusions: Multiple considerations related to the academic environment and individual behaviors seem to influence PWB among college students.

Mental health among U.S. College students: implications of COVID-19 and roles of institutional and individual characteristics

Previous research on college campus environments, student mental health, and COVID-19 has primarily focused on individual-level factors, with limited attention to the broader institutional characteristics. Objective and Methods: Using the national survey data from the American College Health Association, this study examines the influence of both individual-level and institutional-level characteristics on college students' stress, psychological distress, and psychological well-being, before and during COVID-19. Results: (1) COVID-19 significantly impacted students' mental health; (2) institutional-level factors, such as school size, locale, region, and religiously affiliation, were significant predictors of mental health outcomes; and (3) individual-level variables, including gender, age, race/ethnicity, relationship status, moderated the relationship between COVID-19 and mental health. Conclusion: This study suggests the need to consider various institutional contexts in future efforts to understand predictors of mental health conditions and resilience.

Cumulative lifetime stressor exposure impairs stimulus-response but not contextual learning

Greater exposure to stressors over the life course is believed to promote striatum-dependent over hippocampus-dependent learning and memory processes under stressful conditions. However, little research in this context has actually assessed lifetime stressor exposure and, moreover, it remains unknown whether greater cumulative lifetime stressor exposure exerts comparable effects on striatum-dependent learning and hippocampus-dependent learning in non-stressful contexts. To investigate this issue, we used the Stress and Adversity Inventory for Adults (Adult STRAIN) and Multicued Search Task to investigate the relation between cumulative lifetime stressor exposure and striatum-dependent stimulus-response learning and hippocampus-dependent contextual learning under non-stressful conditions among healthcare professionals (N = 205; 157 females, 48 males; Age: M = 34.23, SD 9.3, range 20-59 years). Individuals with moderate, but not low, cumulative lifetime stressor exposure exhibited impaired learning for stimulus-response associations. In contrast, learning for context associations was unrelated to participants' lifetime stressor exposure profiles. These results thus provide first evidence that cumulative lifetime stressor exposure may have negative consequences on human striatum-dependent stimulus-response learning under non-stressful environmental conditions.

Concussion history associated with adolescent psychological distress but not hazardous gambling: a cross-sectional study

BACKGROUND

Sustaining multiple concussions over one's lifetime may be associated with behavioral and mood changes beyond the acute phase of injury. The present cross-sectional study examined the relationship between concussion history, the incidence of current moderate-severe psychological distress, and lifetime adolescent hazardous gambling in high school students.

METHODS

Four-hundred fifty-nine high school students from southern Sweden (age: 16.81 ± 0.83, 58.2% male) completed a survey assessing concussion history (0,1,2…>8), psychological distress using the Kessler-6 scale, and lifetime hazardous gambling using the NODS-CLiP scale.

RESULTS

Participants who self-reported three or more concussions were more likely to endorse moderate-severe symptoms of psychological distress than those with no concussion history while controlling for covariates, OR = 2.71, 95% CI [1.19, 6.18]. In contrast, concussion history was not associated with hazardous gambling after controlling for confounding variables.

CONCLUSIONS

Self-reporting three or more concussions was associated with increased current psychological distress beyond the acute phase of injury among high school students. Adolescents who have sustained multiple concussions should undergo mental health evaluations beyond the acute phase of injury to identify and treat psychological distress, but probing for hazardous gambling may not be clinically relevant in this previously concussed adolescent population.

Testing the Impact of Variations in Administration on the Kessler Psychological Distress Scale (K10)

Self-report measures are useful in psychological research and practice, but scores may be impacted by administration methods. This study investigated whether changing the recall period (from 30 to 7 days) and response option order (from ascending to descending) alters the score distribution of the Kessler Psychological Distress Scale (K10). Participants were presented with the K10 with either different recall periods or different response option orders. There was weak evidence of lower mean K10 scores when using a 7-day recall period than when using the 30-day recall period (B = 1.96, 95% CI [0.04-3.90]) but no evidence of a change in the estimated prevalence of very high psychological distress. Presenting the response options in ascending order did not affect mean scores, but there was weak evidence of reduced prevalence of very high distress relative to the descending order (incidence rate ratio [IRR] = 0.60, 95% CI [0.36-0.98]). These findings suggest that varying the administration method may result in minor differences in population estimates of very high psychological distress when using the K10.

A Community Mental Health Integrated Disaster Preparedness Intervention for Bushfire Recovery in Rural Australian Communities: Protocol for a Multimethods Feasibility and Acceptability Pilot Study

BACKGROUND

Natural hazards are increasing in frequency and intensity due to climate change. Many of these natural disasters cannot be prevented; what may be reduced is the extent of the risk and negative impact on people and property. Research indicates that the 2019-2020 bushfires in Australia (also known as the "Black Summer Bushfires") resulted in significant psychological distress among Australians both directly and indirectly exposed to the fires. Previous intervention research suggests that communities impacted by natural hazards (eg, earthquakes, hurricanes, and floods) can benefit from interventions that integrate mental health and social support components within disaster preparedness frameworks. Research suggests that disaster-affected communities often prefer the support of community leaders, local services, and preexisting relationships over external supports, highlighting that community-based interventions, where knowledge stays within the local community, are highly beneficial. The Community-Based Disaster Mental Health Intervention (CBDMHI) is an evidence-based approach that aims to increase disaster preparedness, resilience, social cohesion, and social support (disaster-related help-seeking), and decrease mental health symptoms, such as depression and anxiety.

OBJECTIVE

This research aims to gain insight into rural Australian's recovery needs post natural hazards, and to enhance community resilience in advance of future fires. Specifically, this research aims to adapt the CBDMHI for the rural Australian context and for bushfires and second, to assess the acceptability and feasibility of the adapted CBDMHI in a rural Australian community.

METHODS

Phase 1 consists of qualitative interviews (individual or dyads) with members of the target bushfire-affected rural community. Analysis of these data will include identifying themes related to disaster preparedness, social cohesion, and mental health, which will inform the adaptation. An initial consultation phase is a key component of the adaptation process and, therefore, phase 2 will involve additional discussion with key stakeholders and members of the community to further guide adaptation of the CBDMHI to specific community needs, building on phase 1 inputs. Phase 3 includes identifying and training local community leaders in the adapted intervention. Following this, leaders will co-deliver the intervention. The acceptability and feasibility of the adapted CBDMHI within the community will be evaluated by questionnaires and semistructured interviews. Effectiveness will be evaluated by quantifying psychological distress, resilience, community cohesion, psychological preparedness, and help-seeking intentions.

RESULTS

This study has received institutional review board approval and commenced phase 1 recruitment in October 2022.

CONCLUSIONS

The study will identify if the adapted CBDMHI is viable and acceptable within a village in the Northern Tablelands of New South Wales, Australia. These findings will inform future scale-up in the broader rural Australian context. If this intervention is well received, the CBDMHI may be valuable for future disaster recovery and preparedness efforts in rural Australia. These findings may inform future scale-up in the broader rural Australian context.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/53454.

Evaluating the Experience of Teen-to-Teen Crisis Line Volunteers: A Pilot Study

Teen-to-teen (t2t) crisis lines are a special type of crisis service where youth volunteers help their peers. Although prior research has examined the experience of adult crisis line responders, no research has examined the experience of adolescents who do this work. In collaboration with two of the largest t2t lines in the U.S., this pilot study is the first examination of t2t crisis line work. Volunteers (ages 14-20) reported: their primary motivation for joining the crisis lines was to help others and give back to the community; responding to a range of peers' problems on the t2t crisis line, including high-risk suicide contacts; and a range of ways the crisis line work impacted their lives. Findings provide preliminary information about the experience of adolescents engaging in t2t crisis line work. Additional research is needed in larger and more diverse samples to understand the impact of crisis line work for youth.

Association between solar radiation and mood disorders among Gulf Coast residents

BACKGROUND

Climate factors such as solar radiation could contribute to mood disorders, but evidence of associations between exposure to solar radiation and mood disorders is mixed and varies by region.

OBJECTIVE

To evaluate the association of solar radiation with depression and distress among residents living in U.S. Gulf states.

METHODS

We enrolled home-visit participants in the Gulf Long-Term Follow-up Study who completed validated screening questionnaires for depression (Patient Health Questionnaire-9, N = 10,217) and distress (Kessler Psychological Distress Questionnaire, N = 8,765) for the previous 2 weeks. Solar radiation estimates from the Daymet database (1-km grid) were linked to residential addresses. Average solar radiation exposures in the seven (SRAD7), 14 (SRAD14), and 30 days (SRAD30) before the home visit were calculated and categorized into quartiles (Q1-Q4). We used generalized linear mixed models to estimate prevalence ratios (PR) and 95% confidence intervals (CI) for associations between solar radiation and depression/distress.

RESULTS

Higher levels of SRAD7 were non-monotonically inversely associated with depression [PRVs.Q1 (95%CI): Q2 = 0.81 (0.68, 0.97), Q3 = 0.80 (0.65, 0.99), Q4 = 0.88 (0.69, 1.15)] and distress [PRVs.Q1 (95%CI): Q2 = 0.76 (0.58, 0.99), Q3 = 0.77 (0.57, 1.06), Q4 = 0.84 (0.58, 1.22)]. Elevated SRAD14 and SRAD30 appeared to be associated with decreasing PRs of distress. For example, for SRAD14, PRs were 0.86 (0.63-1.19), 0.80 (0.55-1.18), and 0.75 (0.48-1.17) for Q2-4 versus Q1. Associations with SRAD7 varied somewhat, though not significantly, by season with increasing PRs of distress in spring and summer and decreasing PRs of depression and distress in fall.

IMPACT STATEMENT

Previous research suffered from exposure misclassification, which impacts the validity of their conclusions. By leveraging high-resolution datasets and Gulf Long-term Follow-up Cohort, our findings support an association between increased solar radiation and fewer symptoms of mood disorders.

Cross-cultural equivalence of the Kessler Psychological Distress Scale (K10) across four African countries in a multi-national study of adults

The Kessler Psychological Distress Scale (K10) has been widely used to screen psychological distress across many countries. However, its performance has not been extensively studied in Africa. The present study sought to evaluate and compare measurement properties of the K10 across four African countries: Ethiopia, Kenya, Uganda, and South Africa. Our hypothesis is that the measure will show equivalence across all. Data are drawn from a neuropsychiatric genetic study among adult participants (N = 9179) from general medical settings in Ethiopia (n = 1928), Kenya (n = 2556), Uganda (n = 2104), and South Africa (n = 2591). A unidimensional model with correlated errors was tested for equivalence across study countries using confirmatory factor analyses and the alignment optimization method. Results displayed 30 % noninvariance (i.e., variation) for both intercepts and factor loadings across all countries. Monte Carlo simulations showed a correlation of 0.998, a good replication of population values, indicating minimal noninvariance, or variation. Items "so nervous," "lack of energy/effortful tasks," and "tired" were consistently equivalent for intercepts and factor loadings, respectively. However, items "depressed" and "so depressed" consistently differed across study countries (R2 = 0) for intercepts and factor loadings for both items. The K10 scale likely functions equivalently across the four countries for most items, except "depressed" and "so depressed." Differences in K10 items were more common in Kenya and Ethiopia, suggesting cultural context may influence the interpretation of some items and the potential need for cultural adaptations in these countries.

Moving Towards Acceptance and Values: A Qualitative Study of ACTforIBD Compared to IBD Psychoeducation

The current study explored perspectives of those with inflammatory bowel disease (IBD) and comorbid anxiety and/or depression on a hybrid acceptance and committment therapy (ACT) intervention, compared to an active control. This qualitative study was nested within a randomized controlled trial (RCT) where an experimental group received an 8-week blended delivery ACTforIBD intervention (four sessions telehealth, four sessions pre-recorded self-directed), while an active control group received a psychoeducation program of similar intensity. Semi-structured interviews were conducted post-intervention and at a 3-month follow-up. Themes were interpreted using reflexive thematic analysis. Twenty individuals participated; ten in each condition. Seven themes were constructed, including three shared themes between groups: I Am Worth Advocating For, Present Moment Is My Biggest Ally, and Ambivalence About Self-Directed Modules. Two themes were identified for the ACTforIBD group: Symptoms Are Going to Happen and Moving Toward Values while two themes identified from the ActiveControl group were: Reset and Refresh and It's Ok to Say No. Acceptance and values modules from ACTforIBD were perceived as useful in reducing psychological distress for those with IBD, while the ActiveControl group felt their program affirmed existing effective coping strategies. Access to external resources for self-directed modules and networking may increase engagement with content long term.

The experience of visual art for people living with mild-to-moderate vision loss

BACKGROUND

Visual art can enhance wellbeing and quality-of-life; however, the experience of visual art for people with mild-to-moderate vision loss has not been examined.

METHODS

Eight participants (6 females, 2 males; Mean age = 81 years, SD = 7.9, range 70-91 years; 4 with mild vision loss and 4 with moderate vision loss based on binocular visual acuity) completed a mixed-methods study comprising: a semi-structured interview on visual art experience; an eye examination; and questionnaires about visual functioning and quality-of-life.

RESULTS

Various themes were identified: visual perception of art (e.g. altered colours, visual distortions, etc.), viewing conditions, elements of art, personal preference, deriving meaning, appreciation of art, impact of impaired visual perception, and social aspects of art.

CONCLUSIONS

The overall experience of art is influenced by how an individual sees, perceives, and makes meaning from art. Even mild vision loss can impair this experience and impact emotional and social wellbeing.

Mental and physical health among 'sandwich' generation working-age adults in the United States: Not all sandwiches are made equal

Objective

This research examined mental and physical health differences by (1) potential upward and downward care recipients and (2) heterogenous time and money transfer arrangements among working-age adults aged 35-64 in the U.S. who are considered to belong to the 'sandwich generation'.

Methods

Data for this study came from the Panel Study of Income Dynamics 2013 Family File and Rosters and Transfers module (n = 4609). For the second study objective, we restricted the analytic sample to individuals with at least one living parent/parent-in-law and at least one child (n = 2228). We varied the sandwich generation experience by whether upward (i.e., to parent), downward (i.e., to children), or transfers at both directions occurred. We then fit a series of logistic regression models to study psychological distress and self-rated health status differences among various classifications of sandwich generation, controlling for basic sociodemographic factors and living arrangements. For both samples, we ran separate models for those without underaged coresident children.

Results

Compared to respondents without potential care recipients, sandwiched individuals do not differ concerning severe psychological distress or poor/fair health. Conditional on being sandwiched between parents/parents-in-law and adult children, providers of both upward and downward time transfers have almost twice the odds of having severe psychological distress while money providers to parents/parents-in-law have about 1.6 times higher odds of reporting poor/fair health status.

Conclusion

This study dispels the notion that being part of the sandwich generation is automatically deleterious to mental and physical health. Rather, it is the provision of certain transfers whilst being sandwiched that is associated with worse health outcomes.

Impact mechanism of social-related social media use on the job performance of caregivers of older adults

This study investigated the impact mechanism of social-related social media use on the job performance of caregivers of older adults through mental health and analyzed gender differences. A total of 358 valid questionnaires were collected and analyzed using SPSS and Smart PLS. The results showed that mental health plays an important role in the relationship between social-related social media use and job performance. Such social media use can improve psychological well-being and reduce psychological distress by promoting relaxation experience. Psychological well-being has a significant positive impact on job performance. In addition, significant differences exist in the impact path of social-related social media use on psychological distress among different gender groups. The findings of this study can assist nursing homes in assessing the use of social media within their organizations and provide methodological references for enhancing the job performance of caregivers of older adults.

Food Insecurity Among Aging SNAP Participants and Eligible Nonparticipants in Two Predominantly Low-Income Black Neighborhoods: Implications for SNAP Enrollment and Outreach for Older Adults

BACKGROUND

The Supplemental Nutrition Assistance Program (SNAP) plays a critical role in alleviating poverty and food insecurity. Despite these benefits, many older Americans who are eligible for SNAP do not participate in the program. Few studies have explored household factors and food insecurity outcomes associated with nonparticipation among older Black Americans.

OBJECTIVES

The study aim was to explore changes in food insecurity and related financial hardship outcomes between 2020 and 2021 among SNAP participants, eligible nonparticipants, and ineligible nonparticipants; compare reasons for not participating in SNAP; and to compare household factors associated with SNAP nonparticipation.

METHODS

Longitudinal design examining data from 2020 and 2021 to assess changes in food insecurity over the course of the coronavirus disease 2019 pandemic.

PARTICIPANTS/SETTING

Participants were 528 adults (aged 30 to 97 years) in households randomly selected from a listing of all residential addresses in two predominantly Black neighborhoods with lower incomes in Pittsburgh, PA, and surveyed between March to May 2020 and May to December 2021.

MAIN OUTCOME MEASURES

Food security was measured using the validated 6-item US Department of Agriculture Adult Food Security Survey Module.

STATISTICAL ANALYSES PERFORMED

Findings are based on a descriptive analysis of food security and related indicators. Statistical testing was performed to assess differences between SNAP participation status and individual characteristics, food security, and financial hardship using Wald F test for continuous measures and Pearson χ2 test for categorical measures. A multivariable linear model was used to assess the association of SNAP participation and eligibility status with change in food insecurity.

RESULTS

In cross-sectional analyses of 2021 data, no differences were observed between SNAP participants and eligible nonparticipants for food insecurity, food bank use, mean weekly food spending per person, and difficulty paying for basics. However, with respect to changes in food insecurity over the course of the pandemic, SNAP participants experienced a greater improvement in mean food security scores between 2020 and 2021 (-0.52 reduction in mean food insecurity score or a 16% improvement in food security; P ≤ 0.05) relative to SNAP-eligible nonparticipants. Perceived ineligibility (71.3%) and perceived lack of need (23%) were the most common reasons for not participating in SNAP.

CONCLUSIONS

More than one-third of SNAP participants and eligible nonparticipants experienced food insecurity and financial hardship. However, there were differences in the changes in food insecurity between these groups.

Analyzing changes in help-seeking from mental and physical health professionals during COVID-19 in Japan

Japan witnessed the outbreak of coronavirus disease (COVID-19) in March - May 2020. We examined whether the impact of COVID-19 on people seeking help from mental and physical health professionals varied with changes in employment (from full-time employment to unemployment or leave of absence) and psychological predisposition to new-type depression (Interpersonal Sensitivity [IS]/Privileged Self [PS]) associated with the pandemic. An online survey was conducted in June 2020 (after the outbreak of COVID-19) among people who were full-time employees as of April 2019. Data from 1,053 individuals were analyzed. The survey asked about regular visits to health professionals one year prior to the survey (June 2019) and at the time of the survey. Employment status, personality traits, and demographic characteristics were also examined. We found that consultation rates changed little before and after the pandemic. Logistic regression analysis showed that after controlling for age and gender, being unemployed or absent from work after the pandemic and having higher scores for IS/PS were positively associated with regular visits to health professionals. Considering that COVID-19 has been shown to increase the incidence of physical and mental illness, the finding that the rate of consultations remained unchanged implies that consultations were withheld. Joblessness/absence from work and IS/PS had negative effects on physical and mental health, leading to fewer visits.

Engagement, Mental Health, and Substance Use Under In-Person or Remote School Instruction During the COVID-19 Pandemic

BACKGROUND

Adolescents' school engagement, mental health, and substance use have been major concerns during the COVID-19 pandemic, particularly given disruptions to school instruction. We examined how the instructional setting was associated with academic and health-related outcomes within an adolescent cohort followed during the pandemic.

METHODS

During 3 semi-annual follow-up surveys, adolescents (N = 1066 students; 2242 observations) from 8 California high schools responded to items measuring academic self-efficacy, school connectedness, internalizing and externalizing problems, and use of substances. Separate generalized estimating equation models predicted outcomes based on the instructional setting.

RESULTS

Relative to in-person instruction, students in remote instruction reported lower academic self-efficacy (Beta: -0.11; 95% confidence interval [CI]: -0.22, -0.01) and school connectedness (Beta: -0.37; 95% CI: -0.48, -0.25), greater odds of past 30-day internalizing problems (AOR: 1.46; 95% CI: 1.09, 1.95), externalizing problems (AOR: 1.36; 95% CI: 1.02, 1.82), and cigarette, cigar, smokeless tobacco, or hookah use (AOR: 2.50; 95% CI: 1.06, 5.91), but lower odds of past 30-day e-cigarette use (AOR: 0.50; 95% CI: 0.30, 0.86).

CONCLUSIONS

Multiple adverse outcomes related to school engagement, mental health, and substance use were associated with remote instruction. To reduce such impacts under future emergencies, schools should rely sparingly on remote instruction and provide appropriate supportive resources.

The association between academic achievement goals and adolescent depressive symptoms: a prospective cohort study in Australia

BACKGROUND

Students define academic competence across two axes: developing skills and understanding (mastery) versus comparisons with peers (performance), and achieving goals (approach) versus avoiding failure (avoidance). We aimed to examine the longitudinal association between achievement goals and adolescent depressive symptoms.

METHODS

We analysed data from the Kindergarten (recruited at age 4-5 years; born between March, 1999, and February, 2000; recruited from March, 2004 to November, 2004) and Baby (recruited at age 0-1 years; born between March, 2003, and February, 2004; recruited from March, 2004 to January, 2005) cohorts of the Longitudinal Study of Australian Children. Participants were identified through the Medicare enrolment database and sampled using a randomised selection stratified by postcode to represent the Australian population. Achievement goals were measured at age 12-13 years with the Achievement Goal Questionnaire (ranges from 1 to 7 on each of the four subscales), and depressive symptoms with the Short Mood and Feelings Questionnaire (score ranges from 0 to 26, with higher scores indicating more severe symptoms) at ages 14-15 years (both cohorts) and 16-17 years (Kindergarten cohort only). Analyses were linear multilevel and traditional regressions, with confounder adjustment, for participants with available data on the exposures, confounders, and outcome.

FINDINGS

We included 3200 participants (1585 female and 1615 male) from the Kindergarten cohort and 2671 participants (1310 female and 1361 male) from the Baby cohort. A 1-point increase in mastery-approach goals was associated with decreased depressive symptom severity score (Kindergarten, -0·33 [95% CI -0·52 to -0·15]; Baby, -0·29 [-0·54 to -0·03]), while a 1-point increase in mastery-avoidance goals was associated with increased depressive symptom severity score (Kindergarten, 0·35 [95% CI 0·21 to 0·48]; Baby, 0·44 [0·25 to 0·64]). A 1-point increase in performance-avoidance goals was associated with increased depressive symptom severity score in the Kindergarten cohort but not the Baby cohort (Kindergarten, 0·26 [95% CI 0·11 to 0·41]; Baby, -0·04 [-0·27 to 0·19]). We found little evidence of an association between depressive symptom severity and performance-approach goals.

INTERPRETATION

Depressive symptoms in adolescents were associated with their achievement goals, which could be targetable risk factors for future trials to investigate whether school-based interventions that aim to enhance factors consistent with mastery goals (ie, learning skills and understanding the subject, rather than assessing competence in comparison to peers) could prevent depression in adolescents.

FUNDING

Sir Henry Dale Fellowship jointly funded by the Wellcome Trust and the Royal Society.

Suicide awareness homophily in adolescent peer support networks: A Swiss cross-sectional social network analysis

Objective

Suicide awareness, encompassing knowledge, attitudes, and behaviors related to suicide, plays a critical role in primary suicide prevention, especially among adolescents. However, little is known about how perceived suicide awareness is apparent in peer support networks in this population. This study examined the presence of suicide awareness homophily in adolescent peer support networks. We also explored other patterns of homophily and identified factors associated with the in-degree popularity of adolescents.

Methods

We used baseline data from a non-randomized, cluster-controlled trial assessing the effectiveness of a universal suicide prevention intervention in Swiss secondary schools (n = 194). We assessed perceived suicide awareness, support networks (including in-degree popularity, i.e., receiving a high number of nominations as a supportive peer), and other covariates. Data were analyzed using social network analyses.

Results

We found evidence of suicide awareness homophily in peer support networks, where adolescents with high suicide awareness were more likely to connect with peers having high suicide awareness (p < .001). The same applied to those with low suicide awareness (p < .001). Age also emerged as a significant homophily factor. Girls (p = .024) and adolescents with high instrumental social support (p = .008) were more likely to be popular in peer support networks.

Conclusions

This study highlighted the homophily of suicide awareness in peer support networks and the need to focus on strengthening peer support networks and promoting suicide awareness in adolescents, particularly for those with low suicide awareness. Future suicide prevention programs, including peer-led interventions, should consider these findings to better target vulnerable subgroups and reduce suicide-related disparities.

Leader workaholism and subordinates' psychological distress: The moderating role of justice climate

Leader workaholism, characterized by an excessive drive to work long hours, is prevalent among organizational leaders. Its impact on subordinates' mental health warrants examination. This study investigated the direct relationship between leader workaholism and subordinates' psychological distress. Drawing on substitutes for leadership theory, it also assessed the buffering effects of procedural, interactional, and distributive justice climates in this relationship. Data from an online survey of 40 leaders and 200 subordinate employees revealed a positive correlation between leader workaholism and subordinates' psychological distress. However, the procedural and interactional justice climates negatively moderated this relationship, whereas the distributive justice climate did not. This disparity may result from the strong link between distributive justice climate and specific, objective outcomes. The study enhances understanding of the adverse effects of leader workaholism on employee psychological health and suggests organizational strategies, such as fostering procedural and interactional justice climates, to mitigate these effects.

Associations between workplace violence and suicidal ideation among Chinese medical staff: a propensity score matching analysis

Physical and mental health problems had been identified as the negative outcomes of workplace violence (WPV) against medical staff. Considering the proven associations between physical and mental health and suicidal ideation, it is reasonable to assume that WPV may associate with suicidal ideation. However, few studies were conducted to explore the relationship between WPV and their suicidal ideation against medical staff. Based on a cross-sectional design, 3, 426 medical staff working in general hospitals were interviewed in Shandong Province, China. Socio-demographic characteristics, work-related factors, psychological variables, WPV, and suicidal ideation were evaluated. Propensity score matching (PSM) was performed to explore the association between WPV and suicidal ideation. The prevalence of suicidal ideation among medical staff was 9.1% (312/3426), and 52.2% (1788/3426) of medical staff reported the WPV experience. Before PSM, we found that the association between WPV and suicidal ideation was statistically significant (aOR = 1.606, p < 0.01). After PSM, there was a statistically significant correlation between WPV and suicidal ideation (aOR = 1.525, p < 0.01). This study supported the correlations between WPV against medical staff and their suicidal ideation. The results of PSM further implied that WPV might cause suicidal ideation among medical staff. Psychological health, especially for suicidal ideation, should be paid attention for medical staff with WPV experiences.

Carry that weight: Parental separation and children's Body Mass Index from childhood to young adulthood

Research has shown that parental separation is associated with worse physical health and unhealthy weight gains during childhood. However, limited empirical attention has been given to the evolution of child health before, upon and following parental union dissolution. Drawing on data from the Child Development Supplement and the Transition to Adulthood Supplement of the Panel Study of Income Dynamics (1997-2017), I investigate whether parental union dissolution during childhood is associated with children's Body Mass Index (BMI) and the risk of developing overweight/obesity in the short and long run (n = 2675 children aged 0-12 in 1997). The results from a combination of propensity score matching and fixed-effects linear regression models show that union dissolution is associated with increases in child BMI and an increased risk of developing overweight/obesity. These changes in children's weight status persist for at least ten years after parental separation. Unhealthy weight gains following parental separation are more pronounced among female children and those with lower-educated and non-White parents. The findings suggest that in the United States parental union dissolution contributes to increase socioeconomic inequalities in child health. Therefore, children with separated parents and lower socioeconomic backgrounds have greater risks of developing overweight/obesity and other obesity-related morbidities over their life courses.

Longitudinal Effects of Electronic Dating Violence on Depressive Symptoms and Delinquent Behaviors Across Adolescence

Depressive symptoms and delinquent behaviors that emerge during adolescence pose both short- and long-term negative outcomes. Though there is growing evidence that exposure to teen dating violence is also associated with a greater likelihood of depressive symptoms and delinquent behaviors such as engaging in peer violence and substance use, less is known about the effects of specific forms of electronic dating violence (i.e., electronic harassment, electronic coercion, and electronic monitoring) across adolescence on depressive symptoms and delinquent behaviors. Data were drawn from a 4-year prospective longitudinal study of two cohorts of youth followed from age 12 to 15 (n = 526, 52% female) and age 15 to 18 (n = 592, 53% female). Two mixed-effects models (stratified by cohort) were employed to evaluate depressive symptoms and delinquent behavior outcomes by exposure to electronic harassment, electronic coercion, and electronic monitoring, while accounting for verbal dating violence, physical dating violence, sexual dating violence, exposure to threat-based adverse childhood experiences, exposure to deprivation-based adverse childhood experiences, and gender across all four waves of data collection. Higher exposure to electronic sexual coercion was predictive of increased depression (β = .015, p = .018). Increased exposure to electronic sexual coercion (β = .007, p = .004) and electronic monitoring (β = .008, p = .045) were both predictive of more delinquency across adolescence. By delineating the effects of in-person verbal, physical, and sexual dating violence with unique electronic domains, we found unique additional risk from domains of electronic dating violence, which was particularly pronounced for youth who reported electronic sexual coercion. Electronic sexual coercion heightens the risk of depressive symptoms and delinquent behaviors in males and females beyond the risk presented by in-person forms of dating violence and should be accounted for in prevention and intervention programs. Future research should explore the effect of perceived normativity on the prevalence of electronic harassment and subsequent influence on outcomes.

Examining Predictors of Psychological Distress Among Youth Engaging with Jigsaw for a Brief Intervention

Risk factors for psychological distress among help-seeking youth are poorly understood. Addressing this gap is important for informing mental health service provision. This study aimed to identify risk factors among youth attending Jigsaw, a youth mental health service in Ireland. Routine data were collected from N = 9,673 youth who engaged with Jigsaw (Mean age = 16.9 years, SD = 3.14), including presenting issues, levels of psychological distress, age, and gender. Confirmatory Factor Analysis identified thirteen factors of clustering issues. Several factors, including Self-criticism and Negative Thoughts, were strongly associated with items clustering as psychological distress, however these factors were poorly predictive of distress as measured by the CORE (YP-CORE: R2 = 14.7%, CORE-10: R2 = 6.9%). The findings provide insight into associations between young people's identified presenting issues and self-identified distress. Implications include applying appropriate therapeutic modalities to focus on risk factors and informing routine outcome measurement in integrated youth mental health services.

Self-objectification in Chinese pregnant women: The mixed role of functionality appreciation

Extensions of objectification theory to pregnant women are few and continued research is needed to better understand the psychological consequences of significant changes to physical appearance during pregnancy. Specific interests in this area include functionality appreciation which may be particularly relevant to pregnancy. Research in this area is also lacking representation of non-Western cultural contexts. To this end, we employed an online survey to assess objectification theory and functionality appreciation in Chinese pregnant women (N = 345). Correlations showed that higher body surveillance and body shame were associated with higher disordered eating and psychological distress, and higher functionality appreciation was associated with lower body surveillance, body shame, and disordered eating. Mediation analyses suggested that higher body surveillance was associated with higher body shame which, in turn, was associated with higher disordered eating and psychological distress. Main effects suggested a negative association between functionality appreciation and body shame, but moderation analyses suggested that higher functionality appreciation strengthened the positive association between body surveillance and body shame. Findings underscore objectification theory as a useful framework to understand eating and body image disturbances and psychological distress in Chinese pregnant women and outline future directions to clarify the temporal nature of these associations and the precise role of functionality appreciation.

SMART Family and Friends: Feasibility and outcomes of a video-conference delivered intervention for families impacted by another's methamphetamine use

INTRODUCTION

Families affected by another's substance use, including methamphetamine, experience harms to their mental and physical health. Yet, research has paid little attention to support and service needs of this population. This pilot study examines the feasibility and outcomes of SMART Family and Friends, a video-conference-delivered mutual-support group targeting families affected by another's methamphetamine use.

METHODS

Recruitment for this study occurred between March-October 2021 via the SMART Recovery Australia website. Participants were English-speaking Australian residents, ≥18 years, affected by another's methamphetamine use, interested in participating in a manualised eight-module group delivered via video-conferencing. Feasibility was evaluated by attendance rates, participant satisfaction, fidelity ratings, and semi-structured interviews. Measures of distress, quality of life, and family functioning assessed outcomes at baseline and one-month post-treatment conclusion.

RESULTS

Forty-three participants commenced SMART Family and Friends groups. 84 % (n = 36) completed ≥4 modules, 67 % (n = 29) completed ≥6, and 42 % (n = 18) completed all 8 modules. Participant satisfaction (M = 4.32, SD = 0.66, out of 5) and facilitator fidelity (>94 % for all modules) were high. A within-group analysis, without comparison condition demonstrated significant improvements in psychological distress (d = 0.38), family impact (d = 0.64), family strain symptoms (d = 0.48), and total family burden (d = 0.69) post-treatment. Qualitative findings illustrated the benefits and challenges of the video-conference-delivered group, as well as recommendations for improvement.

CONCLUSIONS

Results provide initial support for the feasibility and positive outcomes of the SMART Family and Friends program. These findings demonstrate the successful provision of a mutual-support group for affected families delivered via video-conferencing, and merit further sufficiently powered randomised-control-trials to evaluate efficacy.

Exploring the Relationship between Food Insecurity, Chronic Health Conditions, and Serious Mental Illness in the United States: Implications for Social Work

Food insecurity (FI) is a modifiable social determinant of health that impacts approximately 10 percent of the U.S. population. FI has been linked to poorer health outcomes and higher healthcare costs. Given the prevalence of chronic health conditions in the United States, including serious mental illness (SMI), the current study aims to better understand the relationship between FI and chronic conditions, including SMI, in a nationally representative sample. Authors analyzed data from the 2016 Medical Expenditure Panel Survey household component and food security supplement. Findings indicate the prevalence of FI among those with diabetes, lung disease, stroke, and SMI is higher than among the general population, with the prevalence for those with SMI being particularly high (43 percent of the sample). Logistic regression models indicate strong, statistically significant relationships between FI and chronic conditions, including SMI, as well as FI and two or more chronic illnesses, even when controlling for sociodemographic and health factors. There are likely bidirectional relationships between FI and chronic conditions. Findings have implications for social workers, in relation to prevention and treatment of SMI and FI through direct care, advocacy, and integrated services in health, mental health, and social services.

Validation of Arabic versions of the child psychosocial distress screener and pediatric symptom checklist for young adolescents living in vulnerable communities in Lebanon

BACKGROUND

In humanitarian settings, brief screening instruments for child psychological distress have potential to assist in assessing prevalence, monitoring outcomes, and identifying children and adolescents in most need of scarce resources, given few mental health professionals for diagnostic services. Yet, there are few validated screening tools available, particularly in Arabic.

METHODS

We translated and adapted the Child Psychosocial Distress Screener (CPDS) and the Pediatric Symptom Checklist (PSC) and conducted a validation study with 85 adolescents (aged 10-15) in Lebanon. We assessed internal consistency; test-retest reliability; convergent validity between adolescent- and caregiver-report and between the two measures; ability to distinguish between clinical and non-clinical samples; and concurrent validity against psychiatrist interview using the Kiddie Schedule for Affective Disorders and Schizophrenia.

RESULTS

The translated and adapted child-reported PSC-17 and PSC-35, and caregiver-reported PSC-35 all showed adequate internal consistency and test-retest reliability and high concurrent validity with psychiatrist interview and were able to distinguish between clinical and non-clinical samples. However, the caregiver-reported PSC-17 did not demonstrate adequate performance in this setting. Child-reported versions of the PSC outperformed caregiver-reported versions and the 35-item PSC scales showed stronger performance than 17-item scales. The CPDS showed adequate convergent validity with the PSC, ability to distinguish between clinical and non-clinical samples, and concurrent validity with psychiatrist interview. Internal consistency was low for the CPDS, likely due to the nature of the brief risk-screening tool. There were discrepancies between caregiver and child-reports, worthy of future investigation. For indication of any diagnosis requiring treatment, we recommend cut-offs of 5 for CPDS, 12 for child-reported PSC-17, 21 for child-reported PSC-35, and 26 for caregiver-reported PSC-35.

CONCLUSIONS

The Arabic PSC and CPDS are reliable and valid instruments for use as primary screening tools in Lebanon. Further research is needed to understand discrepancies between adolescent and caregiver reports, and optimal methods of using multiple informants.

Factors that influence mental health and well-being of high-performance athletes from Olympic or Paralympic sport who have transitioned out of national-level or international-level sport: a mixed methods approach

Transitioning out of elite sports can be a challenging time for athletes. To illuminate the gaps and opportunities in existing support systems and better understand which initiatives may have the greatest benefit in supporting athletes to transition out of elite sport, this study examined the lived experience of retired elite Australian athletes. Using a sequential mixed-methods approach, quantitative data were collected via a self-report online survey, while qualitative data were collected via semistructured interviews. In total 102 retired high-performance athletes (M=27.35, SD=7.25 years) who competed in an Olympic or Paralympic recognised sport at the national and/or international-level participated in the online survey, providing data across domains of well-being and athletic retirement. Eleven survey respondents opted in for the semistructured interview (M=28.9, SD=6.9 years) providing in-depth responses on their retirement experiences. Using partial least squares structural equation modelling (PLS-SEM), latent variables were identified from the survey data and associations between retirement support, retirement difficulties, retirement experiences, well-being and mental health were determined. Interview data were thematically analysed. The structural model had good predictive validity for all nine latent variables, describing positive and negative associations of retirement experiences, mental health and well-being. Building an identity outside of sport, planning for retirement, and having adaptive coping strategies positively impacted retirement experiences. Feeling behind in a life stage and an abrupt loss of athletic identity had a negative impact on retirement experiences. Implications for sports policymakers are discussed, including support strategies that could better assist athletes in successfully transitioning from elite sports.

Impact of internal identity asymmetry on employee's behaviors and feelings: A mediating role of psychological distress

Individuals may experience internal identity asymmetry when they feel misidentified and believe their colleagues do not recognize their work-related identities. This research examines the impact of internal identity asymmetry on their behavior and emotional outcomes at the workplace in Pakistan. Data was collected through a survey and received responses from 393 participants at different levels of management in various sectors of Pakistan. A partial least square-based structural equation modeling technique has been used to validate the proposed research model and develop hypotheses. The findings indicate that psychological distress has a positive indirect effect on both outcomes, such as individual work performance and well-being during personal and professional base asymmetries time. The result indicates that employees face psychological distress while experiencing internal identity asymmetries, which may decrease the performance and well-being of the employees. Findings highlight the importance of coping strategies in improving the performance and well-being of employees. Managers can be supportive in maintaining a positive workplace environment where individuals can have a more accurate self-perception and a better understanding of their colleagues' perspectives. This, in turn, enables them to adopt appropriate coping strategies to enhance both performance and well-being.

Do multigenerational homes moderate the intergenerational transmission of maternal adverse childhood experiences?

ABSTRACTBackground: Maternal adverse childhood experiences (ACEs) may lead to increased behavioural problems in children. However, the mediating roles of psychological distress and corporal punishment, two common mechanisms underlying the intergenerational transmission of maternal ACEs, in these relations have not been examined in Chinese samples. Multigenerational homes (MGH) are the dominate living arrangement in China; however, limited research focuses on the effects of MGHs on the intergenerational transmission of maternal ACEs.Objective: This study explored the parallel mediating effects of corporal punishment and psychological distress on the association between maternal ACEs and children's behaviour and whether MGHs can strengthen or weaken the relationship between maternal ACEs and corporal punishment or psychological distress.Participants and setting: Participants were 643 three-year-old children and their mothers (mean age of 32.85 years, SD = 3.79) from Wuhu, China.Methods: Mothers completed online questionnaires measuring ACEs, psychological distress, corporal punishment, their family structure, and children's behavioural problems. This study used a moderated mediation model.Results: The findings suggest that psychological distress and corporal punishment mediate the association between maternal ACEs and children's behavioural problems. The mediating role of corporal punishment was found depend on whether mothers and their children reside in MGHs. MGHs were not found to have a moderating role in the indirect relationship between maternal ACEs and children's behaviour problems via psychological distress.Conclusion: Our findings highlight the importance of addressing psychological distress and corporal punishment when designing interventions targeted Chinese mothers exposed to ACEs and their children, especially those living in MGHs.

Things You Do: A randomized controlled trial of an unguided ultra-brief intervention to reduce symptoms of depression and anxiety

The 'Things You Do' encompass five types of actions that are strongly associated with good mental health: Healthy Thinking, Meaningful Activities, Goals and Plans, Healthy Habits, and Social Connections. Ultra-brief interventions which increase how often people perform these actions may decrease depression and anxiety. A two-arm randomized controlled trial (N = 349) compared an unguided ultra-brief intervention based on the 'Things You Do' against a waitlist control. The intervention included one online module, two practice guides, and four weeks of daily text messages. The primary timepoint was 5-weeks post-baseline. The intervention resulted in moderate reductions in depression (d = 0.51) and anxiety (d = 0.55) alongside moderate increases in the frequency of Things You Do actions (d = 0.54), compared to controls. No significant change in number of days out of role or life satisfaction were observed. Treatment completion was high (92 %), most participants reported being satisfied with the treatment (66 %), and improvements were maintained at 3-month follow-up. This study demonstrated that an automated ultra-brief 'Things You Do' intervention resulted in clinically significant reductions in depression and anxiety. Ultra-brief interventions may provide a scalable solution to support individuals who are unlikely to engage in longer forms of psychological treatment.

Navigating the decision-making landscape of AI in risk finance: Techno-accountability unveiled

The integration of artificial intelligence (AI) systems has ushered in a profound transformation. This conversion is marked by revolutionary extrapolative capabilities, a shift toward data-centric decision-making processes, and the enhancement of tools for managing risks. However, the adoption of these AI innovations has sparked controversy due to their unpredictable and opaque disposition. This study employs the transactional stress model to empirically investigate how six technological stressors (techno-stressors) impact both techno-eustress (positive stress) and techno-distress (negative stress) experienced by finance professionals and experts. To collect data for this research, an e-survey was distributed to a diverse group of 251 participants from various sources. The findings, particularly the identification and development of techno-accountability as a significant factor, contribute to the risk analysis domain by improving the failure mode and effect analysis framework to better fit the rapidly evolving landscape of AI-driven innovations.

Factors influencing stress and resilience among Egyptian medical students: a multi-centric cross-sectional study

BACKGROUND

Psychological stress is a common psychological comorbidity among medical students and worsens their quality of life. Psychological resilience is thought to have a protective role against stress. However, evidence regarding the prevalence of stress and resilience alongside their associated factors is scarce, especially in the Middle East. This is the first multicenter, cross-sectional study to investigate resilience and stress among Egyptian medical students.

METHODS

The current cross-sectional study was conducted on 2465 university students in seven public universities in Egypt. The universities were selected using the simple randomization method. The data was collected using a self-administered questionnaire consisting of four parts: demographic data, socioeconomic tool represented in the Family Affluence Scale (FAS), the Kessler Psychological Distress Scale (K10), and the Brief Resilience Scale (BRS). Data was analyzed in SPSS version 26 software.

RESULTS

The majority of the students were stressed (86.5%), most of whom had severe stress (48.9%). Most of the students had low resilience (49.9%), while only 3.2% had high resilience. In the logistic regression analysis, being a female, living alone, spending long hours on social media, and thinking of suicide or leaving medicine were associated with being stressed and having low resilience. Medical students with low resilience were significantly more liable to stress [Adjusted odds ratio (AOR) = 3.667, confidence interval (CI): 2.709-4.965, P = 0.000], and vice versa [AOR = 3.709, CI: 2.746-5.009, P = 0.000]. Interestingly, high socioeconomic status showed a significant association with high resilience (P = 0.004); nonetheless, it was not associated with stress (P = 0.993). Academic grades were not associated with both the level of stress and resilience. Aging, being in clinical or academic stages, smoking, having a chronic disease, and being financially-supported are neither associated with stress nor resilience.

CONCLUSIONS

The present study revealed that Egyptian medical students had low resilience and high stress, with a significant relationship between both of them. Further investigations via longitudinal study design to understand the resilience-stress relationship are recommended. Developing and implementing resilience-improving strategies in medical schools is highly recommended to decrease the prevalence of stress and its subsequent burdens.

Determinants of psychological distress among individuals who are aware of their HIV serostatus in South Africa: findings from the 2017 national HIV prevalence, incidence, behavior, and communication survey

Introduction

Psychological distress is a growing public health challenge among people living with HIV. This study investigated the prevalence of psychological distress among individuals who know their HIV positive or negative serostatus in South Africa using 2017 data from a nationwide cross-sectional household-based population survey.

Methods

The data for this secondary analysis was collected using a multi-stage stratified cluster randomized sampling design. Multivariable backward stepwise generalized linear regression models were fitted to determine factors associated with psychological distress as measured by the Kessler Scale (K10) among HIV-positive and HIV-negative individuals who know their serostatus in South Africa.

Results

Of 18,662 participants, psychological distress was 27.4% (95% CI: 25.3-29.7) among those HIV-positive and 20.1% (95% C: 18.8-21.4) among those HIV-negative. The odds of psychological distress were significantly higher among HIV-positive individuals who rated their health as fair/poor [AOR = 1.22 (95% CI: 1.09-1.35), p < 0.001], and the odds were lower among those residing in rural formal/farm areas [AOR = 0.85 (95% CI: 0.78-0.93), p < 0.001], and those with tertiary education level [AOR = 0.88 (95% CI: 0.78-0.99), p = 0.033]. The odds of psychological distress in HIV-negative individuals were significantly higher among females than males [AOR = 1.09 (95% CI: 1.05-1.14), p < 0.001], high-risk alcohol drinkers [AOR = 1.26 (95% CI: 1.02-1.57), p = 0.035] and hazardous alcohol drinkers [AOR = 1.09 (95% CI: 1.01-1.18), p = 0.028] than abstainers and those who rated their health as fair/poor rather than excellent/good [AOR = 1.18 (95% CI: 1.10-1.26), p < 0.001].

Conclusion

The study underscores the importance of addressing, alcohol misuse and socio-structural inequalities linked to gender and race-based disparities, such as low educational attainment and unemployment, as critical factors associated with psychological distress in the study population.

Social Media Use and Serious Psychological Distress Among Adolescents

Unlabelled

This Research Letter describes the increasing trend of almost-constant social media use among California adolescents and the association with serious psychological distress, focusing on the influence of familial and experiential factors.

Further Exploration of the Correlates of Post-Coital Dysphoria and Its Prevalence within Different Sexual Contexts

The current study investigated the correlates of post-coital dysphoria (PCD) in men and women. Moreover, the study explored the PCD prevalence in the sexual contexts of a relationship, casual sex, and masturbation. An online survey was completed by 156 participants, 51 males and 105 females. All participants were over 18 and have had sex in and out of relationships, as well as having engaged in masturbation. Results showed that PCD was prevalent in each of the three sexual contexts, for both males and females. Furthermore, some previously identified correlates were replicated and found to be statistically significant predictors of PCD. A previously unexplored variable that was also found to significantly predict PCD were negative attitudes toward masturbation. The current research established that PCD occurs in multiple sexual contexts - something previously unknown. Prevalence rates of PCD after sex within a relationship, casual sex, and masturbation, for males were 21.6, 49 and 72.5, respectively. For females, prevalence rates were 11.4, 77.1 and 51.4%, respectively. Additionally, it identified which factors predict the experience of PCD for each of the different sexual contexts for each gender. This has potentially huge implications in formulating a focus for the treatment of PCD, dependent upon the gender and sexual context it is experienced in.

Validity and reliability of the Persian version of food preferences questionnaire (Persian-FPQ) in Iranian adolescents

The assessment of dietary intakes and habits using reliable and youth-specific measurement tools during adolescence is essential. The aim of the present study was to culturally adapt and investigate the psychometric properties of the Persian version of the food preferences questionnaire (Persian-FPQ) among Iranian adolescents. This methodological cross-sectional study was conducted among 452 Persian-speaking adolescents, living in Isfahan, Iran. Translation of the FPQ was performed using forward-backward method. Intra Class Correlation (ICC) and Cronbach's α were used to assess test-retest reliability and internal consistency, respectively. Construct validity was investigated by using exploratory factor analysis (EFA). Divergent validity was determined using correlation analysis with Kessler Psychological Distress Scale (K-10). Known-group validity was assessed based on differences in mean food preference score between boys and girls and different categories of body mass index (BMI). The internal and external reliabilities for the Persian-FPQ were in the range of good to excellent in all domains (Cronbach's α: 0.76-0.96 and ICCs: 0.982-0.998). Boys had higher scores of food preferences than girls, indicating good known-group validity. Construct validity evaluated by EFA led to extraction of seven factors ("Vegetables", "Fruit", "Dairy", "Snacks", "Meat/Fish", "Starches" and "Miscellaneous foods"), explaining 37.8% of the variance. Divergent validity revealed significant negative correlations between five sub-scales of the Persian-FPQ and psychological distress. The Persian version of the FPQ is a reliable and valid instrument with applicability in a broad range of the population of Persian-speaking adolescents for assessing food preferences in community-based research projects.

Community and household-level incarceration and its association with mental health in a racially/ethnically diverse sample of families

This study examines the association between community incarceration rates, household incarceration, and the mental health of parents and children. Participant families had children ages 5-9 (n = 1307) from the African American, Latinx, Hmong, Somali/Ethiopian, Native American, and White communities in the Twin Cities, Minnesota. Linear mixed models were used to estimate associations between parent and child mental health, household incarceration exposure, and census tract race, ethnicity and gender-specific incarceration rates matched to the family's home address and race/ethnicity. Findings indicated that living in census tracts with elevated incarceration rates of men from your same racial or ethnic group was significantly associated with psychological distress in parents and externalizing behaviors in boys, regardless of household exposure to incarceration. The association between incarceration rates and externalizing behaviors was only observed among girls with exposure to household incarceration. Policies that deconstruct pervasive racism in penal systems are needed to improve population mental health.

The feasibility of a psychological first aid intervention as a supportive tactic for feelings of psychological distress and mental health recovery outcomes among earthquake survivors in Northern Syria

AIM

This study aimed to investigate the feasibility of implementing a psychological first aid intervention for psychological distress, resilience capacity, quality and meaning of life among survivors affected by earthquake adversity in Northern Syria.

METHODS

A quasi-experimental, pre-posttest, two-group research design was utilized. A convenience sample of 95 survivors (46 in the study group and 49 in the control group) was recruited for the psychological First Aid intervention at a 1:1 ratio. The psychological first aid intervention was delivered in 10 sessions, twice weekly, followed by 3-month follow-up.

RESULTS

A statistically significant improvement in the mean scores of resilience capacity, quality and meaning of life among survivors, along with a significant reduction in psychological distress, was registered among the study group compared with the control group.

CONCLUSION

Our work verified the suitability of implementing psychological first aid following the catastrophic temblors which struck Northern Syria. Given that the psychological first aid intervention is grounded in psychological safety, cognitive reframing, mobilization of social support and installation of hope, the feasibility of its path following public health emergency, traumatic events or even a personal crisis can be favourable.

Co-designing restrictive practice elimination: A systems thinking approach with mental health service users and practitioners in rural/regional Australia

Elimination of restrictive practices (physical/mechanical restraint and seclusion) from adult acute mental health care services has been demanded internationally for many decades. This study aimed to: (1) Identify priority issues in the elimination of and use of alternative approaches to restrictive practices (seclusion and physical/mechanical restraint) in rural/regional acute adult mental healthcare services, as told by mental healthcare service users and practitioners, (2) identify the community-based, system-level feedback loops that enhance or reduce the use of restrictive practices and viable alternatives and, (3) identify potential action areas to improve system structures to increase regional mental healthcare services' ability to eliminate restrictive practices and use alternative approaches. Group model building (GMB) workshops were held with a small group (n = 9) of mental healthcare practitioners and service users with lived experience of restrictive practice use. This participatory approach enables exploration and visual mapping of local structures causing behaviour patterns of practitioner and service user concern over time - in this case, the barriers, and enablers to alternative approaches to restrictive practices in adult acute mental healthcare services within the Geelong-Barwon region. This is the first study that specifically applies GMB in the discussion of the elimination of restrictive practices in mental health in the non-metropolitan regional/rural context. Participants identified four key priorities in relation to eliminating restrictive practices: (1) self-advocacy, (2) continuity of care, (3) early intervention, and (4) safety for all. The study findings were distilled into a novel preliminary set of mental healthcare practitioner and service user action ideas.

Effects of Racist Microaggressions and Sexual and Gender Minority Stress on Mental Health Among Latinx Lesbian, Gay, Bisexual, Transgender, and Queer or Questioning + Young Adults

This study examines the effects of racist microaggressions and lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ)-related minority stressors (i.e., identity concealment, family rejection, internalized LGBTQ-phobia, victimization, and racialized heterosexism/cisgenderism) on psychological distress among Latinx LGBTQ+ young people, specifically college students. Participants are a Latinx subset (n = 80) from a national online nonprobability cross-sectional survey of LGBTQ+ college students. The study aim was examined using linear/logistic regression. Findings indicated that racist microaggressions and family rejection were associated with psychological distress. In addition, racist microaggressions were the only stressor associated with clinically significant psychological distress that may warrant psychiatric/psychological treatment. Therefore, racist microaggressions and family rejection are unique stressors that may saliently affect mental health among Latinx LGBTQ+ students. There is a great need to integrate minority stress theory with other critically-oriented theories, such as intersectionality, in research and intervention to eliminate mental health inequities faced by Latinx LGBTQ+ young people.

COVID-19, lockdowns, and the mental wellbeing of LGBTQ people in Australia

LGBTQ communities around the world entered the COVID-19 pandemic with generally high rates of poor mental health and faced additional challenges including stigma, discrimination, and barriers to care. This study sample was drawn from a survey of 3135 LGBTQ adults residing in Australia during the pandemic. Regression analysis was used to explore individual differences in psychological distress and perceived change in mental wellbeing since the onset of the pandemic as well as the impact of lockdowns, by taking advantage of a natural experiment comparing the states that experienced more extensive lockdowns (Victoria and New South Wales) to the rest of Australia. The burden of mental health was found to vary across gender, sexual orientation, age, and area of residence. While no impact of lockdowns on psychological distress was observed, participants living in the states of Victoria (β = -0.15; 95% CI = -0.23, -0.07) and New South Wales (β = -0.13; 95% CI = -0.21, -0.05) self-reported a more negative impact of the pandemic on their mental wellbeing compared to the rest of the country. The findings suggest that the COVID-19 pandemic had a negative impact on the mental wellbeing of LGBTQ populations, particularly among those who experienced extensive lockdowns and highlight the need for increased efforts to enable access to mental health supports during times of crisis.

Wiidookaage'win: Beta-test of a Facebook group intervention for Native women to support opioid use recovery

INTRODUCTION

The ongoing opioid misuse epidemic has had a marked impact on American Indian/Alaska Native (AI/AN) communities. Culture- and gender-specific barriers to medically assisted recovery from opioid use disorder (OUD) have been identified, exacerbating its impact for AI/AN women. Wiidookaage'win is a community-based participatory research study that aims to develop a culturally tailored, moderated, private Facebook group intervention to support Minnesotan AI/AN women in medically assisted recovery from OUD. The current study assessed the preliminary feasibility and acceptability of the intervention in a beta-test to inform refinements before conducting a pilot randomized controlled trial (RCT).

METHODS

The intervention was beta-tested for 30 days. Moderators were trained prior to delivering the intervention. Study assessments were conducted at baseline and post-intervention. The post-intervention assessments included substance use (self-report and urine drug screen), treatment acceptability, mental health, and spirituality outcomes. We examined intervention engagement patterns using Facebook metrics and qualitatively explored common topics that emerged in participant posts and comments.

RESULTS

Ten AI/AN women taking medication for OUD (MOUD) were accrued (age range 25-62 years). Participants had been in opioid recovery a mean of 15.2 months (SD = 16.1; range = 3-60). The study participation rate (accrued/eligible) was 91 %. Nine participants completed the post-intervention survey assessment and eight completed a UDS. Acceptability was high based on the mean treatment satisfaction score (M = 4.8, SD = 0.2 out of a possible 5.0), Facebook group engagement, and positive qualitative feedback. All participants retained at post-intervention continued their MOUD treatment, and none had returned to opioid use.

CONCLUSIONS

The beta-test indicated that the Facebook platform and study procedures generally worked as intended and that the intervention was largely acceptable to study participants. The results of this study phase provided valuable insights to inform refinements prior to conducting a pilot RCT to further assess the feasibility, acceptability, and potential efficacy of the intervention.

Preventing postnatal depression in new mothers using telephone peer support: protocol for the DAISY (Depression and AnxIety peer Support studY) multi-centre randomised controlled trial

INTRODUCTION

Postnatal depression affects up to one in six new mothers in Australia each year, with significant impacts on the woman and her family. Prevention strategies can be complicated by a woman's reluctance to seek professional help. Peer support is a promising but inadequately tested early intervention. Very few trials have reported on the efficacy of peer support in the perinatal period and no study has been undertaken in Australia. We will explore if proactive telephone-based peer (mother-to-mother) support, provided to women identified as being at high risk of postnatal depression, impacts on clinically significant depressive symptomatology at 6 months postpartum.

METHODS AND ANALYSIS

This is a protocol for a single-blinded, multi-centre, randomised controlled trial conducted in Melbourne, Australia. Eligible women will be recruited from either the postnatal units of two maternity hospitals, or around 4 weeks postpartum at maternal and child health centres within two metropolitan council areas. A total of 1060 (530/group) women will be recruited and randomly allocated (1:1 ratio) to either-usual care, to receive the standard community postpartum services available to them, or the intervention group, to receive proactive telephone-based support from a peer volunteer for 6 months, in addition to standard community services.

PRIMARY OUTCOME

clinically significant depressive symptomatology at 6 months postpartum as measured using the Edinburgh Postnatal Depression Scale.

SECONDARY OUTCOMES

symptoms of anxiety and/or stress, health-related quality of life, loneliness, perception of partner support, self-rated parenting, child health and development, infant feeding and health service use. The cost-effectiveness of the intervention relative to standard care will also be assessed.

ETHICS AND DISSEMINATION

Ethics approval has been obtained from La Trobe University, St. Vincent's Hospital, the Royal Women's Hospital, Northern Health, Victorian Department of Health and Human Services and Victorian Department of Education and Training. Written informed consent will be obtained from all participants before randomisation. Trial results will be disseminated through peer-reviewed publications, conference presentations and a higher degree thesis.

TRIAL REGISTRATION NUMBER

ACTRN12619000684123; Australian New Zealand Clinical Trials Registry.